Provider Demographics
NPI:1194909648
Name:MORGAN, ANN LOSEE (DOM)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LOSEE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GEORGE CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:EDGEWOOD
Mailing Address - State:NM
Mailing Address - Zip Code:87015-9110
Mailing Address - Country:US
Mailing Address - Phone:505-281-9555
Mailing Address - Fax:
Practice Address - Street 1:5 GEORGE CT
Practice Address - Street 2:SUITE D
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-9110
Practice Address - Country:US
Practice Address - Phone:505-281-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM755171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist